My favorite topic. And as always in the US there will be a lot of fingerpointing and no action....
Obamacare killed the US as a medical mega-power. Economics 101: if you force the same prices for a much larger demand, then either the product sells out, or the service is watered down.
My only experience in Europe is Germany and I much prefer that system over the US. I don't know how it is in other countries.
Germany has its own set of problems but it's still better than the US for most people. The US should compare itself against the best.
Even medical billing is gradually going away with the shift to value-based care and accountable care organizations (ACOs).
We could just do it, cover everyone, for less than we're paying now, by rejiggering the system under a "medicare for all" banner. There aren't any other serious options on the table. (replace and repeal, or whatever, is not a serious option.)
Is that even true? Personally I have my doubts.
FINDINGS
In the aggregate, both Medicare and Medicaid payments fell below costs in 2016:
- Combined underpayments were $68.8 billion in 2016. This includes a shortfall of $48.8 billion for Medicare and $20.0 billion for Medicaid.
-For Medicare, hospitals received payment of only 87 cents for every dollar spent by hospitals caring for Medicare patients in 2016.
- For Medicaid, hospitals received payment of only 88 cents for every dollar spent by hospitals caring for Medicaid patients in 2016.
- In 2016, 66 percent of hospitals received Medicare payments less than cost, while 61 percent of hospitals received Medicaid payments less than cost.
[0] https://www.aha.org/data-insights/2018-01-03-underpayment-me...
Is that even true? Personally I have my doubts.
Is that the actual cost of the item or the obscene markup? Is medicare only paying $2.20 for the $2.50 saline bag, or are they only paying $176 of the $200 charge?
Democrats apparently didn't have the votes to even make Medicare or Medicaid an optional buy-in, to compete with marketplace insurance. This in particular is necessary in a huge land area of the U.S. where there's only one or two insurance providers.
Democrats apparently didn't have the votes
That's not actually true (Republicans had a significant say, even though thet universally ended up voting no), but even if it was the public option had long been controversial among Democratic politicians despite it (and even moreso simple single payer, which had a majority support ) long being overwhelmingly popular among Democrstic voters and having stronger support nationally than the purchase mandate w/o public option approach.
> Republicans were not even allowed to see the bill before the vote was taken,
Yeah, they were, they were also involved in the Committee process in the Senate in which it was drafted. They also filibustered it for quite a while, which gave them even more time in which to read it.
And of course Republicans in the House had still more time to read it, since it was voted on in the House after the vote in the Senate.
There are lots of reasons you can argue might have been behind Republicans voting against, not being allowed to read it is not one of them.
I would have liked to see more experimentation on price transparency.
I don't think my comment was partisan but it was a description of the last 10 years. Republicans voted to repeal Obamacare several times a year but never introduced anything for improving it. And now that they are in power they seem have no idea how to proceed.
I am not saying that Obamacare was a good law. Actually it was pretty half assed but it could probably be made to work with some changes. I would have loved it opponents of it would have introduced steps for improvement but they never did.
I like the concept of the ACA as integrating markets and competition, as opposed to price fixing. Healthcare is a terrible example of market failure which requires some amount of regulation -- I wish we could iterate on which regulations were worthwhile. Instead we have this all-or-none regulation-vs-no-regulation. :(